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CEO & CHIEF MHO Update: March 27, 2020

SENT TO ALL STAFF, MEDICAL STAFF, STUDENTS AND VOLUNTEERS ON BEHALF OF KATHY MACNEIL, PRESIDENT & CEO AND DR. RICHARD STANWICK, CHIEF MEDICAL HEALTH OFFICER


As we come closer to the end of this busy week, we want to thank you for following our daily updates. What stands out to both of us is the incredible commitment and compassion of the Island Health family to move and adapt in this new and evolving response to COVID-19. Thank you. Also, our apologies for the length of today’s memo, but there is important information we want to ensure you have today.

Child Care Update

Late today the Ministry of Health provided updated information to yesterday’s note regarding urgent child care needs beginning next week. As you are aware, the Ministries of Education and Children and Family Development requested health-care workers to submit an excel template (pw: childcare) should they require child care support. Please continue to email in the template if you haven’t already.

The updated information late today – government is recommending you take the additional below actions if there are urgent situations where direct care and supporting care health care workers require care for their children during the week of March 30th:

  • School-Aged Children (K-6): parents should contact their school principals (public and independent) as soon as possible to determine how best to meet the need for urgent child care beginning the week of March 30th. Principals will be available over the weekend for this purpose.
  • Children aged 0-5 (Pre K): parents should contact child care providers that operate on school grounds to see if they have capacity, or call their local Childcare Resource and Referral (CCRR) Centre and they will work to match front-line health care workers with a child care provider that have available space.

Provincial Update: Modelling and Island Health Plans

Today, Provincial Health Officer Dr. Bonnie Henry and Health Minister Adrian Dix shared the BCCDC’s critical care and acute care hospitalization modelling for the progression of COVID-19. The materials are being shared publicly so all British Columbians can see the models underpinning inpatient care planning underway to support the demand we may see in our hospitals in the coming weeks. As you can read in the materials linked above, the provincial government leveraged the expertise of health-care providers including key clinical leads at Island Health, modelled various scenarios based on experience of other countries, and examined the potential impacts to our health system based on the scenarios.

During today’s briefing, Minister Dix noted if BC’s experience is similar to China’s Hubei province, current health authorities’ plans should support projected needs. If the experience is similar to the modelled hospital-based Northern Italy experience, the Minister noted BC would be fully utilizing all acute care sites and bed capacity off hospital sites to enhance critical care access for those who require it. The Minister also spoke to actions underway to increase ventilator capacity in BC to meet projected demands. To read more on Dr. Henry’s and Minister’s Dix’s comments please review the transcript or watch the conference here.

Island Health is advancing a multi-stage plan to prepare for increased acute care demand that will arise. Capacity is already reduced in our hospitals, and we will further reduce capacity if required using other facilities for rehab and ALC patients. We designated NRGH and RJH as our two primary inpatient/critical care COVID-19 inpatient sites. Work is being finalized at these primary sites – and at all acute care sites should they be required – to provide robust capacity and staffing plans by early next week. We are enhancing and preserving our personal protective equipment supplies to support the growth in demand which will occur in our facilities. Enhanced surveillance and monitoring of patients with mild and moderate symptoms has been advanced in the community – including expanded use of virtual care. We are also working closely with BC Emergency Health Services to plan for how we transport patients in the safest way possible.

For those of you actively involved in this planning, keep up the great work. It is amazing to see the plans coming together to position Island Health to best meet the challenge in front of us. As these plans are finalized over the coming days we will share more details with all of our teams.

Dr. Henry’s overall assessment from today’s briefing is we are beginning to see a bend in the curve and we will have a better sense of the trajectory for BC in the next week or two. Early signals are looking optimistic. For us working in health care, this means we are moving in the right direction, doing the right things and responding in the right ways. It isn’t over – not by a long shot – but we should all be proud of the tremendous work that has happened over the past several weeks to prepare.

As of this morning, we have several COVID-confirmed patients admitted at our two primary sites, with the majority of these individuals in ICUs at the two primary sites. By cohorting patients in these two locations, we will help preserve our PPE and better protect health-care workers and patients. Teams have developed solid plans from preparing Emergency Departments at larger sites with special care zones for patients with respiratory and droplet precautions, to our smaller sites, where tents have been set up outside to create safe zones for triage and intake.

Provincial Daily Update on Cases

Provincial Health Officer Dr. Bonnie Henry and Health Minister Adrian Dix shared today that the total number of confirmed COVID-19 cases in Island Health has risen to 57, up five since yesterday. Across BC, there are now 792 cases confirmed, up 67 from yesterday. Two additional deaths occurred in the Vancouver Coastal region. A total of 73 confirmed cases are hospitalized across BC and 275 people who tested positive for COVID-19 have recovered.

Two additional long-term care homes in the Fraser Health region now have staff with confirmed cases. In total 11 long-term care homes have confirmed cases – all in the Vancouver Coastal and Fraser Health regions.  

Updated direction from the Provincial Health Officer on Personal Protective Equipment (PPE)

Earlier today, we received updated direction from the Provincial Health Officer on actions we need to take that preserve our supplies of personal protective equipment to protect health care workers and to support continuation of care. The order included:

  • Securing our PPE supply in one location in each facility.
  • Completing a full risk assessment and point of care assessment for every patient or resident interaction.
  • Health-care workers and other staff who have direct physical contact with patients who are suspected or have been diagnosed with COVID-19, must follow droplet and contact precautions.
  • N95 respirators must only be used for Aerosol Generating Medical Procedures on patients confirmed or suspected of having COVID-19.
  • Health care workers limit their use of PPE.

To this last point, a memo went out to our healthcare team about PPE usage in care areas, which raised many questions. Simply put, we need you to know three key things:

  1. You are supported to do a risk assessment for every patient or resident interaction, to identify suspected or confirmed COVID-19.
  2. Based on that assessment, if you determine the patient has or is suspected of having COVID-19, you must don a mask, eye protection, gloves and a gown.
  3. Once this mask is on – we ask that you keep it on throughout your shift UNLESS the mask is too damp, soiled, or damaged for effective droplet protection, or when you leave the unit, ward or facility.

We appreciate your support and will answer questions that resulted from today’s memo in an FAQ this weekend.

Conclusion

Yesterday, we spoke of the health heroes movement just as Victoria Police Department Officers honoured staff at Royal Jubilee Hospital with a 15 car salute.

PoliceCar

We are so proud of the work you do every day and know you have a community behind you recognizing how incredibly hard it is to be on the front lines of this crisis.

In addition to the many notes of encouragement our health-care family continue to receive via our social media pages and countless public displays of support from our communities, we have received upwards of 500 offers from individuals and local businesses interested in donating goods or services to support our response efforts.

While the news today from the Provincial Health Officer is encouraging news, we know we must continue to focus on the three most important things we can do to flatten the curve – proper hand hygiene, physical distancing, and staying home if you are sick.

Take care of yourselves and each other.

~ Kathy and Richard


Staying informed:

  • Visit Island Health's ‘source of truth,COVID-19 WEB PAGE on the Intranet. Transcripts or recordings of the Town Halls will be posted after each event.
  • The Medical Staff website has specific information for medical staff.
  • We are also posting information for the public on our social media channels. We encourage you to follow/retweet/share BCCDC’s and Island Health’s posts.